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Idaho rates for HCPCS L5638

Addition to lower extremity, below knee (BK), leather socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$402.71 / $556.60 / $647.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$488.48 / $503.81 / $503.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.78 / $367.78 / $817.75
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.13 / $497.11 / $662.14
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.92 / $629.03 / $662.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $488.66 / $581.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$579.79 / $646.62 / $969.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$463.50 / $483.36 / $695.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$388.77 / $388.77 / $388.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.43 / $291.41 / $462.17